Insights: Cancer care in Florida

Breakthroughs, trends and players in the medical field of oncology

New technology at the University of Florida Proton Therapy Institute at Shands Jacksonville is offering hope to patients with metastatic cancer, the spread of the disease from one region of the body to another. Using a new machine called Vero doctors at UF are able to track tumors in real time with image-guided technology and deliver high-dose radiation therapy with a high degree of precision. Dr. Paul Okunieff, a professor and chair of the UF department of radiation oncology and director of the UF Shands Cancer Center, says Vero is particularly useful in targeting tumors that may be moving as the patient breathes or with each heartbeat. "This enables us to deliver the optimum dose of radiation to the tumor, destroying it from the inside out while sparing healthy tissues surrounding it," says Okunieff. The treatment, which is usually given during a five- to 10-day period, has been particularly effective in treating patients who are in an early stage of metastatic disease, with five or fewer lesions. Okunieff, while still at the University of Rochester, was the principal investigator of a study that demonstrated promising long-term survival for patients, and breast cancer patients in particular, with limited metastases. Okunieff says the technology is helping UF's Metastatic Cancer Program achieve its goal of changing metastatic cancer from a terminal condition to one that is manageable or even curable.

Personalized Medicine

It took 20 years and an estimated $3 billion for an army of scientists to decode the human genome, the so-called "genetic blueprint" of human life. Today, the once laborious task of unraveling an individual's genetic makeup can be accomplished in just a few weeks, at a cost of a few thousand dollars.

"We can do things at the genetic level that are literally mind blowing," says Dr. Alexander Parker, a kidney cancer epidemiologist at Mayo in Florida.

That technological revolution is one of the driving forces behind the rise of personalized medicine, which seeks to tailor a patient's care based on his own individual genetic makeup, says Dr. Alexander Parker, a nationally known kidney cancer epidemiologist at Mayo Clinic in Florida and the associate director of Mayo's new Center for Individualized Medicine.

"We're in an exciting age now. We can do things at the genetic level that are literally mind blowing," says Parker. Instead of looking at single genes, Parker says, "we can look at an entire genome for an entire individual" as well as the entire genome of that cancer to "see what's going on."

At Mayo, Parker says he and his colleagues believe genetic sequencing can help them better answer questions "that cover the entire natural history of cancer" -- everything from why it develops and how it can be better diagnosed to why it's more aggressive in certain patients and why some patients experience side-effects from treatments while others don't.